[guided]The delicate point is that we must compare divisors, not just visible points in a picture. Let $L_{X,Y} \subset \mathbb{P}^2_k$ denote the projective line through $X,Y \in E(k)$, with $L_{X,X}$ interpreted as the tangent line to $E$ at $X$. For a plane curve $G \subset \mathbb{P}^2_k$ not containing $E$, define $\operatorname{div}_E(G)$ to be the effective intersection divisor on $E$ whose coefficient at a point is the local intersection multiplicity of $G$ and $E$ there. This is the right object because coincident points are then counted with the correct multiplicity. The smoothness hypothesis on $E$ supplies the local intersection theory on the curve, projectivity allows the degree count from [Bezout's Theorem](/page/Bezout%27s%20Theorem), and the [genus formula for smooth plane curves](/page/Genus%20of%20a%20Smooth%20Plane%20Curve) gives that a nonsingular projective plane cubic has genus $1$.
Define $\Gamma_1 \subset \mathbb{P}^2_k$ by
\begin{align*}
\Gamma_1 := L_{P,Q} \cup L_{-A,R} \cup L_{B,-B}.
\end{align*}
Define $\Gamma_2 \subset \mathbb{P}^2_k$ by
\begin{align*}
\Gamma_2 := L_{Q,R} \cup L_{P,-B} \cup L_{A,-A}.
\end{align*}
Because $A=P\circ Q$, the line $L_{P,Q}$ has intersection divisor
\begin{align*}
\operatorname{div}_E(L_{P,Q}) = P + Q + A.
\end{align*}
This statement includes the tangent case and the case where two of the symbols denote the same point, because the coefficients are intersection multiplicities. Likewise, because $C=(-A)\circ R$,
\begin{align*}
\operatorname{div}_E(L_{-A,R}) = -A + R + C.
\end{align*}
Since $-B$ is defined by the line through $B$ and $O$,
\begin{align*}
\operatorname{div}_E(L_{B,-B}) = B + (-B) + O.
\end{align*}
Adding the three line-section divisors gives
\begin{align*}
\operatorname{div}_E(\Gamma_1) = P + Q + A + (-A) + R + C + B + (-B) + O.
\end{align*}
The same reasoning for the three components of $\Gamma_2$ gives
\begin{align*}
\operatorname{div}_E(\Gamma_2) = Q + R + B + P + (-B) + D + A + (-A) + O.
\end{align*}
Now we state the nine-point principle in the form actually being used. Suppose $G_1$ and $G_2$ are plane cubic curves not containing $E$, and suppose their intersection divisors with $E$ have the form
\begin{align*}
\operatorname{div}_E(G_1) = Z + X
\end{align*}
and
\begin{align*}
\operatorname{div}_E(G_2) = Z + Y
\end{align*}
where $Z$ is the same effective divisor of degree $8$ and $X,Y \in E$. Choose homogeneous cubic equations $g_1$ and $g_2$ defining $G_1$ and $G_2$. Since neither cubic curve contains $E$, the restrictions of $g_1$ and $g_2$ to $E$ are nonzero rational sections of $\mathcal{O}_E(3)$. Quotienting two nonzero rational sections of the same line bundle gives a rational function
\begin{align*}
f:E\dashrightarrow \mathbb{P}^1_k.
\end{align*}
The zero and pole orders of this quotient are exactly the differences of the two intersection divisors, so its [principal divisor](/page/Principal%20Divisor) is
\begin{align*}
\operatorname{div}(f) = X - Y.
\end{align*}
If $X \ne Y$, then $\operatorname{div}(f)\ne 0$, so $f$ is nonconstant. Its pole divisor is exactly the single point $Y$ with multiplicity $1$, so the pole divisor has degree $1$. For a nonconstant rational function on a smooth projective curve, the degree of the induced morphism to $\mathbb{P}^1_k$ equals the degree of its pole divisor; hence $f$ gives a degree-one morphism $E \to \mathbb{P}^1_k$. A [degree-one morphism](/page/Degree%20of%20a%20Morphism) of smooth projective curves is [birational](/page/Birational%20Map). That cannot occur here because birational smooth projective curves have the same [genus](/page/Genus), while $E$ has genus $1$ and $\mathbb{P}^1_k$ has genus $0$. Hence $X=Y$.
We apply this principle with
\begin{align*}
Z := P + Q + R + A + (-A) + B + (-B) + O.
\end{align*}
The divisor identities above say exactly that $\operatorname{div}_E(\Gamma_1)=Z+C$ and $\operatorname{div}_E(\Gamma_2)=Z+D$. Therefore the residual degree-one divisors are equal, and hence
\begin{align*}
C = D.
\end{align*}
This proves the needed geometric equality in all cases, including tangent cases and cases where several of the named points coincide.[/guided]